Settlement money to help stem the decades-long opioid addiction and overdose epidemic is rolling out to small towns and big cities across the U.S., but advocates worry that chunks of it may be used in ways that don’t make a dent in the crisis.
As state and local governments navigate how to use the money, advocates say local governments may not have the bandwidth to take the right steps to identify their communities’ needs and direct their funding shares to projects that use proven methods to prevent deaths.
Opioids have been linked to about 800,000 deaths in the U.S. since 1999, including more than 80,000 annually in recent years, with most of those involving illicitly produced fentanyl.
Drugmakers, wholesalers and pharmacies have been involved in more than 100 settlements of opioid-related lawsuits with state, local and Native American tribal governments over the past decade.
The deals, some not yet finalized, could be worth a total of more than $50 billion over nearly two decades and also come with requirements for better monitoring of prescriptions and making company documents public.
States alone fought the tobacco industry in the 1990s and they used only a sliver of the money from the resulting settlements on tobacco-related efforts.
“We don’t want to be 10 years down the road and say, ‘After we screwed up tobacco, we trusted small government with opioids — and we did even worse,’” said Paul Farrell, Jr., one of the lead lawyers representing local governments in the opioid suits.
He notes that with settlement money rolling out for at least 14 more years, there’s time for towns to use it appropriately, and resources to help.
The goal, experts say, is to help those who are taking opioids to get treatment, to make it less likely people who use drugs will overdose and to create an environment for people not to take them in the first place.
For many, it’s personal.
Suzanne Harrison and her family launched a nonprofit dedicated to getting New Jersey residents access to treatment and recovery programs after her brother and Navy veteran, King Shaffer Jr., died from a fentanyl and heroin overdose in 2016, days before he was scheduled to try another treatment program.
At the time, he was staying with a sister who lived in Moorestown, New Jersey.
That town’s administration decided to hand its portion of settlement money over to Burlington County, which has used settlement funds to distribute an overdose antidote and run camps for kids affected by addiction.
“The County was in a much better position to handle this subject,” township manager Kevin Aberant emailed, noting reporting requirements and restrictions on how the money could be used.
The major opioid settlements, which include deals with Walgreen Co., CVS Health, Walmart, Johnson & Johnson and one with OxyContin maker Purdue Pharma that is before the U.S. Supreme Court, require that most of the funds be used to combat the crisis.
More than half of the funds will be controlled by local governments, according to Christine Minhee, who runs the Opioid Settlement Tracker website. In the biggest agreements, states receive larger amounts by getting eligible local governments with populations over 10,000 to join the settlements.
Unlike most states, New Jersey required local governments to complete reports on the funding.
Using those submissions and additional reporting, media examined the spending and decision-making processes for communities in Burlington County, which includes Philadelphia suburbs and rural areas. Fourteen communities there receive allocations and by last June the amounts ranged from $5,000 to nearly $88,000.
By last year, most communities in Burlington County had not spent their allotted funds yet, nor had they followed advice to gather public input, devise strategic plans, conduct assessments of their communities’ needs and design processes for awarding funds.
In Mount Laurel, New Jersey, the police department was put in charge and launched outreach events around budget motels where first-responders often administer an overdose antidote. The idea is to connect people with treatment and other services, but advocates prefer police not be in charge of the spending.
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